Enlarged LA

Just a quick question, I just had my annual echo done ( cardiologist did not see the need of another Thallium Stress test this year) and everthing is totally normal again with the exception of a mildly enlarged LA at 4.4 CM. My last three echos have shown it's size as 4.2 cm in 2006, 4.9 cm in 2007 and now 4.4 cm. My cardiologist says it does not make my heart structure abnormal and says I no longer need annual cardiac workups as everything has been fine since 2005 when I went in with some mild chest pain, turned out to be a bad gallbladder but they wanted to keep an eye on me. I am 50 yrs old,  do 45 - 60 minutes of cardio EVERY day, controlled HP (110/65 ) good lipds (TC151) I have lost 70 pounds since January 1 2007 (New Years Resolution) but still need to loose 40-50 more, never smoked or drank, with no family history. My cardiologist did say the change in size may be due to a shift in the orientation of my heart with with my weight loss which may have created an incorrect image, does that sound reasonable? Also, since she feels I don't need to continue with annual work ups (which I'm fine with), does and enlarged LA require follow up?

Thanks in advance.

[Darcy Green Conaway, MD]

Enlarged left atriums are often due to diastolic dysfunction and this can be due to obesity, hypertension, etc. If you were morbidly obese than a left atrium that size may be normal.